Montgomery Internal Medicine Group, PC

Simon D. Murray, MD-MDVIP Douglas P. Corazza, MD Ernest J. DeLaCruz, MD

Vickie B. Hug, MD Savneet K. Chattha, MD Laura N. Hildebrant, DO

Elizabeth C. Johnson, Pa.-C

727 State Road, Princeton, New Jersey08540 Phone: 609-921-6410

719 Route 206 N., Hillsborough, New Jersey08844 Phone: 908-904-0920

Patient Welcome Letter

Dear Patients of Montgomery Internal Medicine Group:

We are pleased that you have chosen Montgomery Internal Medicine Group for your medical care. Please read the following information so that we may make your experience with our practice a positive and productive one.

Prescription refills:Before calling our office for a refill, please check with your pharmacy if any refills are present. For proper medical care, patients MUST be seen within 6 months to obtain a refill. If your insurance company requests a 3 month mail in order, please allow ample time for the order to be received through the mail. The patient is responsible to mail in the prescription. The office staff will make every effort to refill a prescription on the same day it was requested. Always check with your pharmacy first, before picking up your prescription.

Referrals: Our office staff requests that you give at least seven (7) working days notice to process a referral to a specialist under your managed care plan. (Please ask for our referral form outlining the referral process.)

No Show and Cancellation Fee: A 24-hour cancellation notice is required for all appointments. A fee of $50 will be implemented if required notice is not given.

Medical Records: Written authorization from the patient/parent or guardian must be obtained to release medical records. At leastone week’s notice is required to complete your request for medical records. The cost is $1 per page when records are released directly to the patient. There is no charge if records are forwarded directly to a new physician.

Our private pay and non-insured patients will be asked for payment at the time of service. We accept assignment on Medicare patients.

Over the last few years our telephone call volume has increased exponentially. We have hired more staff and improved out telephone system to meet that demand. That having been said, there may be times when the call volume is such that you may be asked to leave a message or be put on hold in order to handle the calls in an orderly and professional manner. Please understand that we will do our best to handle all calls as quickly and efficiently as we can. Any medical emergencies will be handled immediately by calling our emergency number which is 609-683-8894. Thank you for your cooperation.

WE DO NOT PARTICIPATE WITH MEDICAID

PAYMENT IS REQUIRED AT THE TIME SEVICES ARE RENDERED.

A FEE OF $35 WILL BE CHARGED FOR ALL RETURNED CHECKS.

IT IS THE RESPONSIBILITY OF THE PATIENT TO NOTIFY OUR OFFICE OF ANY INSURANCE AND/OR DEMOGRAPHIC CHANGES.